PREDICTORS OF PERINATAL OUTCOME IN INTRAUTERINE GROWTH-RETARDATION - A LONG-TERM STUDY

Fifty-three intrauterine retarded fetuses (IUGR) and seventy-five heal thy pregnancies were monitored by neurobehavioural profile (quiet stat e or S1F and activity state or S2F percentages) and umbilical artery D oppler velocimetry (UA RI) on two occasions between the 27th-32nd and the 33rd-36th week of gestation.The aims of the present study were the following 1) to relate S1F, S2F and RI to mild and severe IUGR 2) to relate behavioural state analysis and UA Doppler velocimetry to the fo llowing perinatal outcomes: Cesarean section (CS); Preterm delivery (P D); small for gestational age (SGA); Apgar score at 1st and 5th min < 7; Respiratory Distress Syndrome (RDS); Neurological Injury (NI) (eval uated at the birth, the 4th, the 8th and the 12th month of life). 3) t o establish the best predictors of perinatal outcome with these monito ring parameters by a stepwise computerized processing. Our results sug gest: 1) mild IUGR, characterized by a progressive increase in periphe ral vascular resistances, positive diastolic peak flow (RI: 0.72 +/- 0 .01; mean +/- SD), is associated with gradual increase in S1F (12.51 /- 2.84; mean +/- SD) and a decrease in S2F (27.51 +/- 2.81; mean +/- SD) percentages; 2) severe IUGR, characterized by zero or negative dia stolic peak flow (UA RI --> 1), is associated with a significant incre ase in S1F (21.32 +/- 12.11; mean +/- SD) and a decrese in S2F percent ages (30.93 +/- 20.35; mean +/- SD). In conclusion: S1F is the best pr edictor of severe IUGR and significant for all the perinatal outcomes selected; S2F is the best predictor of mild IUGR and significant for S GA; UA RI is the best parameter for recognizing mild IUGR and evolutio n to severe IUGR.